Monroe County New York Nursing Homes as Repeat Offenders

Monroe County nursing homes have been cited for numerous deficiencies that often place residents at risk, yet they are still open for business; a Rochester nursing home remained open for two years after receiving chronic violations from the government. Democrat and Chronicle, a newspaper in Rochester, NY found that more than 1/3 of violations received have been cited by Department of Health (DOH) inspectors during previous or checkup inspections (repeat offenses). In some instances, the conditions that led to repeat citations were the basis of wrongful death lawsuits.

There are 34 nursing homes in Monroe County, all of which were cited for a total of 768 state and federal violations during the period of 2012 to 2015; 38% of those citations were repeat deficiencies. The DOH is supposed to ensure that nursing homes comply with regulations of minimum standards of care by making random visits every nine to 15 months and posting the results of inspections online. However, many believe this method is not enough and the state should do more as a means of enforcement. Rose Marie Fagan, a citizen of the town of Victor said that there is no reason for less than excellent nursing home care and that the community should demand better for the elderly.

Owners of nursing homes believe that variations in Medicare reimbursement rates and complex regulations contribute to repeat incidents; they also believe that citations do not provide an accurate sense of the home’s quality. Vice President, Mark Klyczek of the Long Term Care Division of Rochester stated that he does not believe in excuses and his goal is to receive deficiency free surveys. The spokesman of the DOH and spokeswoman of the U.S. Centers for Medicare and Medicaid services declined comment.

In 2001, an investigation division from the House Committee on Government Reform was called to examine the enforcement of New York’s nursing home regulations, the report concluded that the state could do better. In February 2016, the New York State Comptroller urged the DOH to fine homes with repeat violations. Nursing home regulations are extensive and complex. Bob Hurlbut, owner of Hurlbut Care Communities, said it is more important to judge a facility based on whether a resident was harmed based on a violation.

When state health inspectors cite a violation, they also note how many residents were affected and whether there were any injuries. Susan Murty, Vice President and Administrator of St. Ann’s Community, stated that it is not only important to deal with these incidents properly but also to report these incidents properly. Murty provided an example of an incident that occurred at the home where she works to show how a nursing home come could receive a citation. One of the residents at the home hit another resident on top of the head; the incident was not reported because no one was injured. The DOH was on site for an inspection when they learned of the incident which resulted in a full investigation and citation for not reporting resident-to-resident abuse; this created a repeat deficiency under that regulation.

Hurlbut ran six nursing homes in Monroe County at the time of the analysis, with deficiencies ranging from 36 at one home to 12 at another. Hulburt reasoned that there are many variables at play in nursing homes; some residents are more chronically ill which can place the facility at higher risk for potential deficiencies. Rationalizing a high number of deficiencies may seem like an excuse to a family, which is a conversation that Klyczek would like to avoid. Klyvzek stated that Rochester Regional is expanding its daily safety check program for hospitals and nursing homes. This program requires administrators to convene to write a plan of correction and determine if one home has a better practice that other homes should follow. The team currently meets weekly to conduct mock surveys and play the role of inspectors looking for problems which helps them to identify issues that health inspectors are looking for and to take steps in prevention.